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Underground Storage Tank <br /> Designated UST Operator Visual Inspection Report <br /> 10 . TESTING AND MAINTENANCE Se No NA Date <br /> last <br /> performed <br /> Has monitoring system certification been completed within the past 0 ❑ 7=15 =20 <br /> 12 months? <br /> Has spill container testing been completed within the past ❑ : . 7=15 -20 <br /> 12 months ? <br /> Has overfill prevention equipment inspection been completed within 1:1 ❑ 11 -2019 <br /> the past 36 months ? <br /> Has secondary containment testing been completed within the past ® ❑ ❑ 4 01 M21 <br /> 36 months? <br /> Has tank tightness testing been completed within required ❑ ❑ 0 <br /> timeframes ? <br /> Has line tightness testing been completed within the required 0 ❑ <br /> timeframes ? <br /> Other Test I Maintenance : ❑ ❑ ❑ <br /> Other Test ! Maintenance : ❑ ❑ ❑ <br /> Other Test I Maintenance : ❑ ❑ ❑ <br /> 11 , FACILITY EMPLOYEE TRAINING Ye No <br /> s <br /> Have all individuals performing facility employee duties received the required facility ❑ <br /> employee training within the past 12 months ? <br /> 13 , COMMENTS <br /> Al! answers marked "No " must be described by the designated UST operator in Section 3. <br /> Page 4 of 4 <br />